ICD-10 CAN Help Physicians Give Better Patient Care

The key thing for physicians to know about ICD-10 (International Classification of Diseases, version 10, set to transition in the U.S. on October 1, 20142015) is that if they are using good clinical documentation practices,  coders will do the hard work of expressing the information in ICD-10.  Much of the burden of ICD-10 comes to those physicians who currently do not document the details of the patient condition.

Those that do will feel less pain from the ICD-10 transition. The number and type of new concepts required for ICD-10 are not foreign to clinicians. The focus of the documentation should really be about good patient care. Patients deserve accurate and complete documentation of their conditions.

If other industries understand the value of accurate and complete documentation of data about encounters, shouldn’t healthcare?

ICD-10 reimbursement will introduce changes based on what was done and why. Certainly any physician interested providing good care cannot argue with this? Clinicians should be leaders in the healthcare industry by providing accurate data, accurate analysis of the data and change in healthcare to continuously improve the value their patients receive. Some of the key concepts:

  1. Complete observation of all objective and subjective facts relevant to the patient condition
  2. Documentation of all of the key medical concepts relevant to patient care currently and in the future
  3. Coding that includes all of the key medical concepts supported by the coding standard and guidelines
Note: Some material in this blog was developed in partnership with Health Data Consulting

Michael F. Arrigo

Michael is Managing Partner & CEO of No World Borders, a leading healthcare management and IT consulting firm. He serves as an expert witness in Federal and State Court and was recently ruled as an expert by a 9th Circuit Federal Judge. He serves as a patent expert witness on intellectual property disputes, both as a Technical Expert and a Damages expert. His vision for the firm is to continue acquisition of skills and technology that support the intersection of clinical data and administrative health data where the eligibility for medically necessary care is determined. He leads a team that provides litigation consulting as well as advisory regarding medical coding, medical billing, medical bill review and HIPAA Privacy and Security best practices for healthcare clients, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, physician compensation, Insurance bad faith, payor-provider disputes, ERISA plan-third-party administrator disputes, third-party liability, and the Medicare Secondary Payer Act (MSPA) MMSEA Section 111 reporting. He uses these skills in disputes regarding the valuation of pharmaceuticals and drug costs and in the review and audit of pain management and opioid prescribers under state Standards and the Controlled Substances Act. He consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises ERISA self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $8 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, studies at Stanford Medical School - Biomedical Informatics, studies at Harvard Medical School - Bioethics. Trained in over 10 medical specialties in medical billing and coding. Trained by U.S. Patent and Trademark Office (USPTO) and PTAB Judges on patent statutes, rules and case law (as a non-attorney to better advise clients on Technical and Damages aspects of patent construction and claims). Mr. Arrigo has been interviewed quoted in the Wall Street Journal, New York Times, and National Public Radio, Fortune, KNX 1070 Radio, Kaiser Health News, NBC Television News, The Capitol Forum and other media outlets. See https://www.noworldborders.com/news/ and https://www.noworldborders.com/clients/ for more about the company.

Leave a Reply